Dequervain Tenosynovitis (Wrist Tendinitis)

DeQuervain tenosynovitis causes pain and swelling on the thumb side of the wrist. It may be difficult to open doorknobs, turn keys and grasp objects. The pain can radiate into the thumb and increases with twisting of the wrist.

This is caused by swelling of the tendons which extend the thumb. The tendons are irritated by movement and become even more swollen and painful with continued use.

Initial treatment consists of rest, modification of activity, thumb spica splint, nonsteroidal anti-inflammatory medication and a cortisone injection. This is successful in over 60% of patients. If this fails, surgical release will alleviate the problem. At surgery, the roof of the first extensor compartment is opened to decompress the tendons. Additional separate compartments are also released. This allows the tendons to glide back and forth freely. At Central Jersey Hand Surgery, this procedure is performed under local anesthesia, as same day surgery, and usually takes less than 20 minutes. A small soft dressing or light splint is applied to the hand.

An abstract of a paper written by Gary M. Pess, M.D., of Central Jersey Hand Surgery, on DeQuervain tenosynovitis can be found on the Internet in Wheeless' Textbook of Orthopaedics.

 

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